DeWitt County Form

2023 DeWitt County Farm Bureau Foundation

Scholarship Application
2023

DEWITT COUNTY FARM BUREAU FOUNDATION

SCHOLARSHIP PROGRAM REQUIREMENTS

Scholarship Amount

7 scholarships will be available, ranging from $500 to $1,000.

Eligibility

·        Student must reside in DeWitt County or be the dependent of a DeWitt County Farm Bureau voting member.

·        If applying for the high school scholarship program, student must be graduating from high school in spring 2023 and be accepted at a Junior College, College, University or Technical School as a full-time student.

·        If applying for the college scholarship program, student must be enrolled as a full-time student at a Junior College, College, University or Technical School.

·        Student must be majoring in an agriculture related field. Note, “ag-related field” is a broad term.

Deadline and Review Process

Applications for both the College and High School scholarships must be received in the DCFB office by 11:59 p.m. on Monday, April 3rd, 2023.

Applicants for the High School scholarship will be interviewed at the DeWitt County Farm Bureau office after school on Wednesday, April 6th, 2023.

College scholarship applicants will not be required to complete an in-person interview.

All applications should be typed. Information contained in applications will be kept confidential.

For additional information, contact:

Grace Clark, Manager
DeWitt County Farm Bureau
o. 217-935-2126
dewittcountymanager@gmail.com
Part I-Applicant's General Information
Date of Birth*

MonthDayYear
Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Home Number*

Area CodePhone Number
Cell Phone Number*

Area CodePhone Number
Email
example@example.com
Are you, your spouse, or a parent/guardian a member of the DeWitt County Farm Bureau*
Father's/Guardian's Name*

First NameLast Name
Father's/Guardian's Email*
example@example.com
Father's/Guardian's Phone Number*

Area CodePhone Number
Father's/Guardian's Occupation *
Mother's/Guardian's Name*

First NameLast Name
Mother's/Guardian's Email*
example@example.com
Mother's/Guardian's Phone Number*

Area CodePhone Number
Mother's/Guardian's Occupation *
Part II-Applicant's Academic Information
I am...*

High School SeniorCollege FreshmanCollege SophomoreCollege JuniorCollege Senior
Current High School/College*
Date of Graduation *
G.P.A*
4.0 or 5.0 scale
Class Rank (if in College put in 0)*
Please list out of how many
Please provide any academic awards you have received while in high School/college. (If none, please type NONE)*
Please provide any college scholarships you have already received while in high School/college. (If none, please type NONE)*
Part III-Academic Plans
Name the college, university, or vocational school you are attending or plan to attend.*
Briefly state your intended major field of study in higher education.*
Describe how you think your course of study will benefit the field of agriculture or teaching. *
Explain your career goals. *
Part IV: Activities
List the student activities in which you participate in or have participated. Indicate offices and positions of leadership you held, as well as any honors you received based on your participation. (If none, please type NONE)*
List the community activities (not directly connected with high school/college) in which you have participated. Indicate offices and positions of leadership you have held, as well as any honors you have received based on your participation. (If none, please type NONE)*
Describe any employment you have had during school or during summer vacations. (If none, please type NONE)*
Part V: Interests
Briefly summarize your experience or interest in agriculture/agribusiness/teaching *
What hobbies or special interests do you have?*
Part VI: Financial Analysis
Since financial need is one factor in selecting the recipient of the DeWitt County Farm Bureau Scholarship, the following information will help the Scholarship Review Committee in its deliberations. The information is strictly confidential and will only be reviewed by the Scholarship Review Committee.
Will you work during the school year to support your education?*

YesNo
If yes, where and what is your type of work? (If none, please type NONE)*
Do you intend to work during the summer?*

YesNo
If yes, where and what is your type of work? (If none, please type NONE)*
Do you have siblings? If so how many? Are they attending some type of higher education? (Format example: Jane Doe, 21, Attending Lake Land College (If none, please type NONE))*
Explain your plan to finance your college tuition. *
Why do you feel you should be awarded a scholarship? *
Do you reside with your parents? *
If you do not reside with your parents/guardians, please let us know whom you do live with. *
High School - Character Recommendation
Collegiate - Character Recommendation
Please remember that the following must be sent to the DCFBF

- Current Official High School or College Transcript

- One Current Character Recommendation

- Applicants Picture

Please drop off/send or email them to:

DeWitt County Farm Bureau Foundation

1060 IL-54

Clinton, IL 61727

or mail to

P.O. Box 517

Clinton, IL 61727

dewittcountymanager@gmail.com

There is a dropbox inside the door where you can drop off your application after hours.

Once you submit your application you will receive an email with the Character recommendations blank copies to pass on to those you choose to fill out. They are also due back on Monday, April 3rd, 2023.

Scholarship applications and forms must be completed and submitted to the DeWitt County Farm Bureau office by 11:59 p.m. Monday, April 3, 2023. Applications not fully complete and not accompanied by an official transcript will not be considered for funding.
By checking the boxes below you agree that all information in this scholarship application is true to the best of your knowledge. If you are under the age of 18, please have a parent check that they agree. *

I agree that all of the information is filled out as honestly and to the best of my ability.If applicable, I, the guardian of this applicant, agree to the terms above.I understand my application is incomplete until all documents are received at the DCFBF.
Signature

Clear
Should be Empty:

Now create your own Jotform - It's free!Create your own Jotform

2023 DeWitt County Farm Bureau Foundation